MBI lookup for CMS eligibility checks

A Medicare Beneficiary Identifier (MBI) is a unique, randomly-generated identifier assigned to individuals enrolled in Medicare. You must include the patient’s MBI in every eligibility check you submit to the Centers for Medicare and Medicaid Services (payer ID: CMS). When patients don’t know their MBI, you can use Stedi's eligibility check APIs to perform an MBI lookup using their Social Security Number (SSN) instead.

To perform an MBI lookup:

  1. Construct an eligibility check request with the patient’s first name, last name, date of birth, and Social Security Number (SSN).

  2. Set the tradingPartnerServiceId to MBILU. This is a special payer ID that tells Stedi to perform an MBI lookup for the patient in addition to a standard eligibility check.

  3. Stedi returns a complete benefits response from CMS with the patient's MBI in the subscriber object for future reference.

Visit our Medicare Beneficiary Identifier (MBI) lookup docs for complete details.

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